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Nasal congestion: why can't I breathe well through my nose?

Written by: Mr Irfan Syed
Published: | Updated: 27/02/2020
Edited by: Top Doctors®

 To know the different causes of your nasal breathing problems, you need to go to the ENT Specialist. This specialist is the only doctor who has the appropriate technical means - the nasal fibroscope - to examine the inside of your nose and make a correct diagnosis. Without seeing the inside of the nose the diagnosis may not be correct. After this initial exploration, other examinations may be necessary, such as allergy tests. 

 

 

The most common reasons for nasal congestion:

Diverted nasal partition

The nasal septum separates both nostrils in the midline of the nose. Occasionally, spontaneously, during growth, the development of the face or due to trauma, a deviation in the position of the septum and nostrils occurs, forming an "S" and causing unilateral or bilateral nasal breathing difficulty.

Treatment: The only effective treatment to resolve these deviations is surgery. This surgery is performed from the inside of the nostril, leaving no marks or external cuts.

 

Chronic rhinitis

An inflammation of the nasal mucosa and an increase in the size of the turbinates.

The turbinate is a structure found in the nostrils. The centre is composed of bone and the function is to condition the air we breathe making sure it arrives in optimal condition in the lungs: it filters, heats and moistens the air that we inspire. An increase in size of the turbinates (hypertrophy), especially of the inferior ones, causes respiratory nasal difficulty.

The turbinate increases in volume and there is less free space to breathe. In addition to breathing badly through the nose, it is common to have transparent mucus (runny nose), decreased smell, nasal itching and sneezing. Most of the time chronic rhinitis is caused by an allergy. Allergies are more frequent in spring due to pollen (hay fever), but can occur at any time of the year due to dust mites etc.

Treatment: the treatment for chronic rhinitis is drugs, namely antihistamines and nasal sprays with corticosteroids. Occasionally, medication doesn’t improve the condition and minimally invasive surgery such as Turbinate Radiofrequency surgery can be performed to reduce the size of the turbinates.

In this surgery, high frequency energy is applied by the introduction of an electrode through each nostril. It is done as an outpatient procedure, and the patient is able to go home a few hours after the operation. There are few risks and few complications, and the results are usually satisfactory.

 

Chronic rhinosinusitis and nasal polyposis

These are inflammations and infections of the mucosa and paranasal sinuses that cause nasal respiratory difficulty, abundant mucus and pain or facial pain.

Treatment: the treatment is initially with medication, with the option of surgery for cases with symptoms that are difficult to control and repetitive. Surgical cases are treated by nasal endoscopic surgery through the nostrils without external scars.

By Mr Irfan Syed
Otolaryngology / ENT

Mr Irfan is a leading London ENT and facial plastic surgeon. He treats a wide range of general and paediatric ENT conditions and has a special interest in rhinology (nose and sinuses) and performing facial plastic surgery (nasal reconstruction and management of skin lesions).

He gained fellowship sub-specialty training in rhinology and facial plastic surgery at St George's Hospital London and the Sino-Nasal Institute of Florida. He was awarded the British Rhinological Society Bursary Award for training at the Sinus and Nasal Institute of Florida and the European Rhinological Society Award for training at the Amsterdam Medical Centre. His international training has also taken him to Paris and Vancouver.

In addition to his clinical work, Mr Syed is well recognised for his role in post graduate surgical teaching and is course director for the London Endoscopic Sinus Surgery course, the London Facial Plastic Surgery course, the London ST3 course and the London FRCS (ORL-HNS) Viva course. He has been invited to teach on a number of national and international courses including the Step by Step Rhinoplasty Dissection Course in London and the London Facial Aesthetic Cosmetic Training Course. He is the author of a number of textbooks in medicine and surgery. He has published extensively in peer reviewed literature and presented his work internationally.

He is currently a specialist advisor to the Care Quality Commission and an active committee member for ENT-UK, working to improve the training of future ENT surgeons.

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